Should varicella vaccine be administered to a healthy child who has an immunocompromised household contact, such as a sibling with leukemia?
ACIP and AAP recommend that healthy household contacts of immunocompromised persons be vaccinated. This is the most effective way to protect the immunocompromised person from exposure to wild-type varicella. However, because of the small risk of household transmission of vaccine virus, vaccinees who develop a vaccine-related rash should avoid contact with immunocompromised persons while the rash is present. To date, there have been no documented cases of transmission of varicella vaccine virus to immunocompromised persons. If a susceptible immunocompromised person is inadvertently exposed to a person with a vaccine-related rash, post-exposure treatment with varicella zoster immune globulin (VZIG) is not needed because the disease associated with this type of transmission would be expected to be mild. On the basis of available data, the benefit of vaccinating susceptible household contacts of immunocompromised persons outweighs the low potential risk of transmission of vaccine virus to
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